Antenatal care and homoeopathy-What homoeopathy offers to a pregnant woman

Dr V Priyanka

PLAN OF PRESENTATION

• Introduction
• What pregnancy mean to a woman?
• Antenatal care?
• Aims and objectives of Antenatal care.
• Approach of  modern medicine people.
• What homoeopathy offers a pregnant woman?
• Hyperemesis Gravidarum& Homoeopathy
• Tocophobia
• Miscarriage & Homeopathy
• Hydatidiform mole & Homoeopathy
• Amniotic fluid disorders & Homoeopathy
• Hypertensive disorders in pregnancy and Homoeopathy
• Anaemia during pregnancy and Homoeopathy
• Gestational Diabetes Mellitus& Homoeopathy
• False labor pains and Homoeopathy
• Malpresentation, malposition & Homoeopathy
• Haemorrhoids, Constipation during pregnancy & Homoeopathy
• Prolonged pregnancy & Homoeopathy
• Threatened preterm labor and Homoeopathy.
• Bibliography

INTRODUCTION:
A nation’s health starts with healthy mother, she should have normal and natural pregnancy, delivers a healthy child with good first cry and good APGAR score. So childbirth of this order will give to the nation with their good mental capacity.

It is job of an obstetrician in our country because the more normal and safe delivery is the more intelligent the newborn will be.“you can tell the condition of a nation by looking at the status of it’s women.

What Pregnancy Means To A Woman ?

Pregnancy is a special time for woman and her family. It is a time for many changes in pregnant women’s body in her emotions, in her actions and in the life of her family. This all changes bring the extra stress on her and with in her.

ANTENATAL CARE
Systematic supervision (examination and advice) of a woman during pregnancy is called antenatal (prenatal) care. The supervision should be regular and periodic in nature according to the need of the individual. Actually prenatal care is the care in continuum that starts before pregnancy and delivery and the postpartum period.

AIMS AND OBJECTIVES OF ANTENATAL CARE

The aims are:

• (1) to screen the “high risk” cases
• (2) to prevent or to detect and treat at the earliest any complication
• (3) to ensure continued risk assessment and to provide ongoing primary preventive health care,
• (4) to educate the mother about the physiology of pregnancy and labor demonstrations, charts and diagrams (mother craft classes), so that fear is removed and psychology improved,
• (5) to discuss with the couple about the place, time and mode of delivery, provisionally, and care of the newborn,
• (6) to motivate the couple about the need of family planning and also appropr advice to couple seeking medical termination of pregnancy.

The objective is to ensure a normal pregnancy with delivery of a healthy baby from a healthy mother.

The criteria of a normal pregnancy are

• delivery of a single baby in good condition at term (between38 and 42),
• with fetal weight of 2.5 kg or more
• with no maternal complication.

Visits:

• The first visit should not be deferred beyond the second missed period
• Interval of 4 weeks up to 28 weeks.
• At the interval of 2 weeks up to 36 weeks, and thereafter weekly till delivery.

APPROACH OF  MODERN MEDICINE PEOPLE.

MCP CARD –mother and child protection card.

What is MCP CARD ?
MCP card is a maternal and child care entitlement card, a counselling and family empowerment tool which would ensure tracking of mother and child cohort for health, nutrition and development purpose. As the first contact between pregnant woman and health care system, the MCP card has the potential to create awareness facilitate community and generate demand for uptake of vital services being provided.

Contents in MCP card :

1. Family identification
2. Pregnancy record – LMP,EDD, No of pregnancies/ live births,

                                  Last delivery conducted at& etc….

1. Birth record
2. Institutional identification
3. Regularcheckups

• Blood pressure
• Blood – Hb%
• Urine –albuminous/ proteinuria
• Weight gain –10-12 kgs gain , – 1 kg/ month last 6 months
• TT injection – 2 TT,.  1) pregnancy confirm,

2) after one month

• Iron folic acid tablets –1 tab / day – upto 6 months (180)
• 2 tab calcium / day – up to 6 months after 1 month.
• Albendazole 1  tab (400 mg) –after First trimester.

Modern medicine / Homoeopathy medicine

	Homoeopathy	Allopathy
Makeup	Natural and herbal	Chemical
Expiry date	Life long	Expires
Dosage	Atomic form	Milligrams and grams
Mode of action	Effect on root cause	Effect on disease not on root cause
Route	Tongue	Oral, IM and IV
Absorption	With in seconds	Minutes to hours
Duration of action	Days to months	4-8 hours
Efficacy	100% efficient / single dose cures also	Recurrence
Way to cure	Boosts immune system, Cure is permanent	Directly on organisms, Temporary
Constitutional	Always	Never
Holistic approach	Always	Never
Fetus or newborn	Friendly	Risky
Multiple problems	Single remedy	Multiple drugs

What homoeopathy offers to a pregnant woman :
“Homoeopathic medicine don’t cause side effects because only a minute amount of the ingredient is used in their preparation. They work by stimulating the bodies healing power. Homoeopath recognize the symptoms of I’ll health are expressions of disharmony with in the whole person and that is the person who needs treatment rather than the disease alone”

On the other hand if the fetus is genetically diseased or received some hereditary dyscrasia from it’s parents, no amount of Antenatal care and nutrition to the expected mother or hygienic precautions can make the child born healthy, unless the hereditary dyscrasia is removed by constitutional, anti miasmatic treatment of the mother during pregnancy.

The best procedure to treat such cases  is to treat their parents constitutional disturbances, before they are expecting to have child.

Constitutional:

Carbonitrogenoid ( psora) –

fear, anxiety, restlessness,Functional ailments,threatenedabortion.

Hydrogenoid ( sycotic) :

Gonorrheal infections, mal position and mal presentation

Oxygenoid( syphilitic) :

Destructive changes, abnormal pregnancy, habitual abortions

MIASMATIC APPROACH :
Hahnemann declared that the miasmatic theory was the result of 12 years of the most pain taking work on difficult cases of chronic character combined with his own historical research into the disease of man.

The use of miasms in treatment:

Many physicians routinely give the corresponding nodsode to the mother or child.

Eg: to a child born with syphilitic skin vesicles they might give syphilinum rather than similimum.

This would seem an inappropriate use of the miasmatic concept, as the similimum what patient need not the nosode.

Routine use of nosodes in an expectant mother:

The routine use of psorinum,medorrhinum and syphilinum is in general frowned upon because it is the similimum that patient needs and that will cure. Certainly the nosodes can do good work, but it should be used when it becomes the similimum not just routinely.

Dr.Hahnemann theory about chronic diseases:

The physician skilled in anti miasmatic prescribing dips deeper into the case, and applies an agent that has deep closer relationship with the disturbed life force. The results are always better- organon of medicine.

Prophylaxis:

Mother’s treatment and purification of fetus :
Advisable to give the mother sulphur 30 two globules and allow to act for six weeks after which a dose of calcarea 30 is allowed to act for six weeks. Applicable to all cases and has the effect of purifying the fetus from psoric trait.

H/o of skin disease in parents–two doses of sulphur 200 at the intervals of two months and after the same interval one dose of 1 M potency to the mother.

Venereal tainted women: Two doses of Merc 200 and one dose of 10 M

To evert the syphilitic effecting the child syphilinum 30 every 15 days and Merc 6 daily in the morning throughout the pregnancy until the child sucks the mothers breast. One dose of Merc 6 to the child if in spite of the above child wasting.

HYPEREMESIS GRAVIDARUM

Definition:

It is a severe type of vomiting of pregnancy which has got deleterious effect on the health mother and/or incapacitates her in day-to-day activities.

General management/Conservative treatment

Advice woman to

• Take small frequent meals instead of three major meals.
• Ginger and Vitamin B, rich diet such as whole grains, nuts, seeds, and legumes may reduce nausea and vomiting.
• Eat foods rich in protein, like nuts etc.
• Avoid citrus juices, milk, coffee and tea around meals. Do physical exercises like early morning walk etc.

Homoeopathic management:

Sepia
Chilly patient; predisposed to take cold at the change of weather; thin built with narrow pelvis; yellow saddle across nose; past history of repeated abortions; sudden prostration with sinking faintness with all complaints; offensive sweat; desire for vinegar, acids, pickles and sour, but sour food aggravates; aversion to food; sad, indifferent even to loved ones, irritable, indolent and quarrelsome.

Particular symptoms

• Nausea with sour eructation’s, especially in morning before eating; from sight or thought of food and the smell of cooking food, better by eating

• Empty, all gone sensation in stomach Vomiting of milky water in morning.

• Worse after milk, especially when boiled Everything tastes too salty

COLCHICUM AUTUMNALE
Chilly patient; internal coldness and tendency to collapse; weak and restless; rheumatic diathesis; great prostration, rapid sinking; easily affected by external impressions i.e. Light, noise, strong odors, contact, etc., depressed, irritable and sensitive.

• • Nausea and faintness from the odor of cooking food, fish, eggs or fat meat.
  • Vomiting of mucus, bile and food.
  • Sensitive to sight, smell and thought of food.
  • Profuse salivation. Burning or icy coldness in stomach and abdomen.
  • Sensitive to sight, smell and thinking of food.
  • Great thirst but no appetite.
  • Nausea is better by lying quietly and perfectly still, is renewed by every motion.
  • Craving for various things, but is averse to them after smelling.

ARSENIC ALBUM
Chilly patient, rapid disproportionate prostration; burning pains better by heat (except headache); cadaveric odor of discharges and body, frequent thirst for small quantity of water, craving for acids, coffee and milk; anxiety, anguish, fear of death, restlessness.

• • Nausea, retching, vomiting especially after eating or drinking
• Vomiting of food, drinks, mucus, bile; yellowish, greenish, brownish or blackish in color, serous vomiting; violent pain in the abdomen during vomiting.
• Cannot bear the sight or smell of food.

IPECACUANHA
Over-sensitive to both heat and cold; fatty, tendency to gastric disturbances; thirstlessness with clean tongue. Ailments from: overeating, ice, rich foods, raisins, cakes and smoking tobacco.

• Constant and continual nausea with no relief even after vomiting. Vomiting of food, bile, blood, white glairy mucus; sometimes immediately after meals. Vomiting worse by stooping.
• Moist mouth, with much saliva.

NUX VOMICA:
Chilly patient; thin, dark complexion; spare, quick, active; prone to indigestion and hemorrhoids, sedentary lifestyle; tongue coated yellowish in the posterior part, desire for stimulants, nervous disposition; oversensitive to external impressions, to noise, odors, light or music, etc.; zealous and irritable, impatient, spiteful with violent action; ardent nature.

Ailments from: coffee, alcohol, spicy and highly seasoned food; lack of sleep. Patient is haggard and sick in the morning. Nausea and vomiting, with much retching ;retching predominates over vomiting. Sour taste, constant nausea in the morning, after eating.

• Wants to vomit, but cannot and feels “If I could only vomit I would be so much better.”

PULSATILLA
Hot patient, marked changeability; thirstless with great dryness of mouth; tongue coated yellow or white; though she feels chilly, she is better in open air, worse in the evening; better by slow, gentle motion; desire for cheese, pungent things, highly seasoned food, sausage; aversion to fatty food, meat, butter, bread, warm foods and drinks and smoking, craving for ice-cream and pastry, desire for company, mild, gentle, affectionate, yielding, weeping disposition.

• Ailments from: rich fat food, cake, pastries, pork and sausages.
• Nausea and vomiting in evening and night, after eating or drinking or during a meal. Vomiting of food eaten long before.
• Water brash with foul taste of mouth in the morning
• Sour, bitter eructations; belching of rancid food. Taste of food remains for long time after eating. Vomiting and purging at the same time.

TOCOPHOBIA
Definition
Tocophobia, also known as ‘Fear of Pregnancy’, and ‘Fear of Childbirth’ is a pathological fear of pregnancy and can lead to avoidance of childbirth.

Homoeopathic management:

ACONITUM NAPELLUS :

• Ailments from fright
• Great worry, intense fear and anxiety over trivialailments.
• Fear of death or of the future.
• Face is expressive of fear.
• Intense nervous restlessness, tossing about in agony.
• Does everything in great haste.
• Music is unbearable, makes her sad.

ARSENIC ALBUM:

• Irritable, sensitive, peevish and easily angered.Attacks of anxiety at night driving out of bed, worse after midnight
• Fears: of death, of being left alone, of goingwith cold sweat Anxiety, anguish, fear of death and restlessness

ACTEARECEMOSA :

• Fear of death, of being alone and at night
• Horse riding in a closed carriage, obliged to jump
• Great depression with dream of impending evil.
• Sensation as if a heavy, black cloud had settled over her and enveloped her head so that all is darkness and confusion
• Delusion as if she is going crazy, tries to injure herself
• Illusion of rat or mouse running under her chair.

IGNATIAAMARA:

• Effects of long-concentrated grief and worry.
• •This remedy often is helpful if a mother feels tense, upset or grief-stricken after becoming pregnant. Changeable mood; thoughtful; silently brooding. Melancholic, sad, tearful; silent fear. Defensiveness; hysterical behavior, sighing and sobbing
• Sudden outburst of tears or laughter, insomnia.
• Melancholic, sad, tearful, silent grief. Childish behavior.

NUXMOSCHATA:

• Changeable mood; one moment laughing, the next crying
• Thinks she has two heads.  Complaints accompanied by drowsiness and sleepiness Absent minded; cannot think.
• Weakness or loss of memory.

PULSATILLA:

• Fears: in the evening, to be alone, darkness, ghost.
• Fear of death and insomnia during pregnancy. Craving for sympathy, which relieves.
• Easily discouraged .
• Very emotional, weeps easily, almost impossible to detail her ailments without weeping, weeps when talking.

MISCARRIAGE AND HOMOEOPATHY
DEFINITION: Abortion is the expulsion or extraction from its mother of an embryo or fetus weighing500 g or less when it is not capable of independent survival.

SABINA –

• Habitual abortion especially at third month.
• Pain from sacrum to pubis, and from below upwards shooting up the vagina.
• Hemorrhages where blood is partly fluid and party clotted.
• Atony of uterus.

SECALECORNUTUM:

• Ailments from: lifting.
• Threatened abortion about the third month with copious flow of thin, black and watery blood.
• Burning pain in uterus.
• Pulse: feeble, rapid and intermittent.

ACTEARECEMOSA:

• Ailments from: overexertion.
• Tendency to abort at the third month.
• Intolerance of pain; pains like electric shocks here and there; pains fly across the pelvis, from side to side and from hip to hip; patient doubling up; sympathetic with ovarian or uterine irritation.
• Fainting spells.

CROCUS SATIVUS :

• Threatened abortion, especially when hemorrhage is dark and stringy Surging of blood to genitals.
• Threatened abortion especially when uterine hemorrhage is dark, clotted in long string, words from least movement.

SEPIA :

• Tendency to abort between 5 to 7″ month. Relaxed pelvic organs with bearing down sensation, as if everything will escape from vulva.
• Must sit down and cross legs to ameliorate pressure from pelvis.
• Terrible itching of vulva.

HELONIAS:

• Sensation of weakness, dragging and weight in the sacrum and pelvis, with great languor and prostration.
• Weight and soreness in womb.
• Atonic uterus. Dark, foul blood from uterus.
• Consciousness of the womb.

VIBURNUM OPULUS:

• Frequent and very early miscarriage, causing seeming sterility.
• Often prevents miscarriage. Colicky pains in pelvic region.
• Consciousness of the womb.
• Pains begin in the back and go around from there and end with cramps in the uterus.
• Pains from the back to loins, worse early morning.

HYDATIDIFORM MOLEMolar pregnancy or vesicular mole – Hydatidiform mole or ‘molar pregnancy is characterized by abnormal proliferation of placental trophoblastic cells. These abnormal cells distend the uterus and secrete hormone human chorionic gonadotropin (hCG) mimicking a normal pregnancy.

SABINA :

• Promotes expulsion of moles from uterus.
• Uterine pains extend to thighs.
• Drawing pains in small of back, from sacrum to pubes and from below upwards shooting up the vagina.
• Hemorrhage: partly clotted partly fluid; worse from least motion.

CANTHARIS:

Expels moles, membranes, etc. Constant discharge from uterus; worse false step. Lancinating and tearing pain in coccyx.  Black swelling of vulva with irritation.

PULSATILLA:

• Uterine moles.
• Pains rapidly shifting from one part to another, accompanied with constant chilliness.
• Pain in back; tired feeling.
• Pains associated with suffocative and fainting spells. Weak pains. Bearing down sensation worse while lying down.

KALI CARBONICUM:

• Uterine moles.
• Uterine hemorrhage; constant oozing after copious flow, with violent backache, relieved by sitting and pressure.

SILICEA:  Uterine moles. Promotes expulsion of moles.

AMNIOTIC FLUID DISORDERS
Oligohydramnios
Oligohydramnios is defined when the amniotic fluid volume is less than 300 ml. at term or half than expected at any gestational age .Sonographically it is defined when the maximum vertical pool of liquor is less than 2 cm .or when amniotic fluid index (AFI) is less than 5 cm. Scanty liquor so often seen in many women should not be designated as oligohydramnios in true sense.

Polyhydramniosa
Polyhydramnios is a condition in which the amniotic fluid volume is more than twice the expected volume for the age of gestation normal volume is 50 ml. at 12 weeks, 400 ml. at mid pregnancy and 1000 ml. at term).

If it is more than 2000 ml. at any time, it is called polyhydramnios.

Homoeopathic management

-Constitutional homoeopathic treatment can be given on the basis of symptom similarity with emphasis on causative factors.

HYPERTENSIVE DISORDERS IN PREGNANCY
Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality.

Pre eclampsia:
Preeclampsia is a multisystem disorder of unknown etiology characterized development of hypertension to the extent of 140/90 mmHg or more with proteinuria after the  20 th week in a previously normotensive and nonproteinuric woman.

Eclampsia: Preeclampsia when complicated with grand mal seizures (generalized tonic-clonic convulsion and/or coma is called eclampsia.

Homoeopathic management:

APIS MELLIFICA

• Ailments from fright, vexation and bad news during pregnancy
• Hypertension due to Renal cause.
• Acute inflammation of kidneys and other parenchymatous tissues; urine: suppressed, loaded with casts, high colored.
• Puffy swelling: under the eyes.
• Edematous swelling of hands and feet; feel too large.
• Heat, throbbing, pressing pain in head; better by
• pressure, worse motion. Dull, heavy sensation in occiput.
• Feet swollen and stiff.

MERCURIUSCORROSIVUS :

• Hypertension due to renal cause.
• Frontal pain with congestion of head.
• Albuminuria especially in early pregnancy (Phosphorus for later pregnancy and at full term. Tenesmus of bladder and rectum.
• Headache aggravated looking sideways.
• Double vision or objects appear smaller.
• Albuminuria during pregnancy, esp. if gout is present.

CINCHONA OFFICINALIS :

• Intense throbbing in head and carotids;
• sensation as if skull would burst.
• Dullness and confusion of head as if blood rushed to the head.
• Urine turbid, dark and scanty.

HELONIASDIOICA :

• Albuminuria during pregnancy with obstinate vomiting.
• Often an involuntary passage of urine after the bladder
• Urine profuse and clear. feels emptied.
• Dull aching pain and heat in the region of kidney.

GLONINE:

• Ailments from: heat of sun.
• Headache: throbbing, bursting, congestive;
• cannot lay head on pillow; increases and decreases with sun.
• Sensation as if blood is surging to head and heart. Arterial hypertension.
• Nephritis with headache.
• Urine: profuse, pale, more frequent at night; albuminuria.

SEPIA :

• Ailments from anger, vexation and over-exertion.
• Headache in terrible shocks; worse motion, stooping, and mental exertion.
• Violent intermittent palpitations, beating in all arteries.
• Urine: thick and foul smelling, with red colored Involuntary urination, during first sleep.

ANEMIA DURING PREGNANCY
Anemia is defined as reduction in circulating hemoglobin mass below the critical level. The normal hemoglobin (Hb) concentration in the body is between 12-14 gms %.

WHO has accepted up to 11gm% as the normal hemoglobin level in pregnancy. Therefore any hemoglobin level below 11gm% in pregnancy should be considered as anemia.

Homoeopathic management:

ALETRISFARINOSA :

• Marked anemia due to nutritional disturbances.
• Fainting spells, with vertigo.
• Tired, dull, heavy and confused.
• Suffers from prolapsus uterus, leucorrhea, rectal distress etc.

CINCHONA OFFICINALIS:

• Gradually progressive anemia.
• Face pale, hippocratic;
• eyes sunken and surrounded by blue margins.
• Weakness.

CALCAREAPHOSPHORICA :

• Anemia due to nutritional disturbance,
• after acute diseases and chronic wasting diseases.
• Pale, yellowish face. Chlorosis with wax like complexion.
• Dull Headache particularly on the top of the head;
• head sensitive to jar and pressure.

FERRUM PHOSPHORIC:

• Anemic patient with violent local congestion.
• Night sweats due to anemia.
• Ferrum phosphoricum 3x has been found to be effective in increasing hemoglobin. (Research study conducted by CCRH)

NATRUMMURIATICUM:

• Anemic headache, from sunrise to sunset; with paleface, nausea and vomiting.
• Dyspnea while ascending stairs or from physical .
• Maximum weakness is felt in the morning, in bed exertion. Tachycardia.
• Palpitation, fluttering and intermittent action of the heart.

PULSATILLA:

Often indicated after abuse or over abuse of iron tonics.

GESTATIONAL DIABETES MELLITUS
Gestational diabetes is the glucose intolerance of variable degree that is first recognized during pregnancy.

Introduction

• It is characterized by hyperglycemia of varying severity diagnosed during pregnancy (without previously known diabetes)and usually(but not always) resolving within 6 weeks of delivery.
• It risks to the pregnancy itself include congenital malformations, increased birth weight and an elevated risk Of perinatal mortality.
• It causes increased risk to woman of developing diabetes (T2D or Type 2 diabetes) later in life.

Homoeopathic management

Constitutional homoeopathic treatment can be given on the basis of symptom similarity.

FALSE LABOR PAINS

• False labor pains are contractions, which occur at irregular and unpredictable intervals.
• The woman feels pain and discomfort in the abdomen.
• These are more commonly seen in primigravidae than in multiparous women.
• Pains usually appear prior to the onset of true labor pains, 1-2 weeks before in primigravida and few days before in multiparous women.

Homoeopathic management:

BELLADONNA:

• False labor pains come and go suddenly.
• Pain usually in short attacks, cause redness of face and eyes.

CAULOPHYLLUM:

• • Intermittent, or erratic or paroxysmal severe pain fly in all directions without progress.
  • Short, irregular, spasmodic, tormenting pains.
  • Corrects deranged vitality and produces efficient pains, if the symptoms agree.
  • False labor pains; want of tonicity of womb.

ACTEARECEMOSA:

• False labor-like pains; sharp pain across abdomen; sleeplessness.
• Severe, spasmodic pains, worse by least noise. When given during last month of pregnancy shortens labor, if symptoms correspond.

PULSATILLA:

• Pains rapidly shifting from one part to another, accompanied with constant chilliness.
• Pains associated with suffocative and fainting spells .
• Bearing down sensation worse on lying down.

NUX VOMICA:

• False labor pains extend to rectum with frequent desire for stool and urination.
• Pains tingling, sticking, aching, worse from motion and contact.
• Very irritable, cannot bear to be touched.

CHAMOMILA:

• Pains spasmodic, distressing, tearing, extending down the legs.
• Drawing pains from sacral region forward; griping and pinching pain in uterus.
• Pains pressing upwards.
• Dragging pain towards the uterus like labor pains and frequent urging to urinate.

MALPOSITIONS AND MALPRESENTATION
Malpositions are abnormal position of the vertex of the fetal head (with the occiput as the reference point) relative to the maternal Malpresentations are all presentations of the fetus other than vertex.

PULSATILLA :

• Almost specific for malpresentation of the fetus
• Transverse lie
• Give two doses, each dose at the interval of one week after 28 weeks only when liquor is adequate. (Research study conducted by CCRH).

HEMORRHOIDS AND CONSTIPATION – PREGNANCY

AESCULUS HIPPOCASTANUM:

• Engorged hemorrhoidal veins, with absence of actual constipation; accompanied by a severe lumbo-sacral backache.
• Dryness and heat of rectum; sensation as if full of small sticks; knife-like pains shoot up the rectum.
• Hot, dry, stiff, rough and full feeling in the rectum.
• Constipation with hard, difficult, large, dry stool with dryness and heat of rectum.
• Stool followed by fullness of rectum and intense pain in anus for hours; with prolapse.
• Hemorrhoids: blind, painful, burning, purplish; rarely bleeding. Burning in anus with chills up and down the back.

COLLINSONIA :

• Sensation of constriction and of sharp sticks in rectum as if sands or gravel had lodged in rectum . Chronic, painful, incessant bleeding piles associated with severe constipation.
• Stools sluggish, hard and dry with pain and great flatulence. Itching of anus.
• Alternate constipation and diarrhea.
• Piles ultimate with respiratory, heart or rheumatic symptoms.

SEPIA :

• Dragging sensation in the lower abdomen. Bleeding at stool and fullness of rectum; great tenesmus; pains shoot upward.
• Constipation: large, hard stools; feeling of a ball in rectum not relieved by stool; dark-brown, round balls glued together with mucus. Has to remove stool manually.
• Aggravation while standing; hemorrhoids prolapse and bleed on walking.

NUX VOMICA:

• Ailments from: sedentary habits; night watching, stimulants like coffee, alcohol and spicy and highly seasoned food.
• Irregular peristaltic action of the intestines causing frequent ineffectual desire for stool, or passing small quantity at each attempt; feeling as if part of the stool remained unexpelled.
• Very painful, non-bleeding piles, with ineffectual urging for stool. • Constant uneasiness in rectum.
• Severe itching in the piles, better by sitting in a tub of cold water.

PROLONGED PREGNANCY
Pregnancy which has continued for more than 2 weeks beyond expected date of delivery.

It may lead to

• Functional placental insufficiency because fetus outgrows the placenta.
• Death of the fetus in uterus before, during and after labor.
• Higherincidence of meconium aspiration, oxytocin induction, shoulder dystocia, macrosomia, oligohydramnios, fetal heart abnormalitiesand cesarean sectionincidence.

Homoeopathic management:

OPIUM : Labor pains wanting.

CAULOPHYLLUM: Extraordinary rigidity of os. Want of tonicity of womb.

THREATENED PRETERM LABOR
Increased uterine irritability leading to uterine contractions without producing change in the cervix before 37 completed weeks of gestation.

SEPIA:

• Premature labor pains between 5^th and 7^th months
• Relaxed pelvic organs with bearing down sensation, as if everything will escape from vulva.
• Must sit down and cross legs to ameliorate pressure from pelvis.

OPIUM:

• Premature labor pains due to fright or shock especially in last month of the pregnancy.
• Horrible labor like pains in uterus with urging to stool.

BIBLIOGRAPHY:

1. Dc Dutta’s  Textbook Of Obstetrics –Hiralal Konar – 8Th Edition .
2. Homoeopathy For Mother And Child Care -Volume 1 [ Central Council For Research In Homoeopathy]
3. Homoeopathic Therapeutics – The Classical Therapeutic Hints – Samuel Lillianthal ,Md.
4. Boericke’s New Manual Of Homoeopathic Materia Medica With Repertory – Willium Boericke.
5. Lecuters On Homoeopathic Materia Medica – J T Kent
6. Repertory Of The Homoeopathic Materia Medica- J T Kent
7. Homoeopathic Medical Repertory- Robin Murphy
8. Repertory Of Hering’s Guiding Symptoms Of Our Materia Medica- Calvin. B Knerr.
9. Homeobook.Com

Dr V.Priyanka
P.G.Scholar, Part- 1,
Dept Of Case Taking & Repertorisation
Dr. G.G.H. Medical College,Gudivada.